Skip to content
Nonprofiteer
← COMMUNITY HOSPITAL HEALTH FOUNDATION

Form 990 for tax year 2022

Filed by COMMUNITY HOSPITAL HEALTH FOUNDATION.

Totals

Total revenue
$1,727,377
Total expenses
$489,649
Contributions and grants received
$1,631,751
Grants paid
$451,820
Program service revenue
$0
Investment income
$140,223
Other revenue
-$44,597
Total assets, end of year
$5,851,906
Total liabilities, end of year
$14,416
Net assets or fund balances, end of year
$5,837,490
Program services expenses (Part IX)
$451,820
Management and general expenses
$31,965
Fundraising expenses
$5,864
Program service expenses (Part III)
$451,820

Program services were 92.3% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1c · Fundraising events

    $90,120

  • 1d · Related organizations

    $78,809

  • 1f · All other contributions, gifts and grants

    $1,462,822

  • 3 · Investment income

    total $105,050 · excluded $105,050

  • 7a · Gross sales of assets other than inventory

    securities $1,491,552

  • 7b · Less cost or other basis and sales expenses

    securities $1,456,379

  • 7c · Gain or loss

    securities $35,173

  • 7d · Net gain or loss

    total $35,173 · excluded $35,173

  • 8a · Fundraising events: gross income

    $31,626

  • 8a · Fundraising events: contributions included on line 1c

    $90,120

  • 8b · Fundraising events: direct expenses

    $76,223

  • 8c · Net income from fundraising events

    total -$44,597 · excluded -$44,597

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $431,851 · program services $431,851

  • 2 · Grants to domestic individuals

    total $19,969 · program services $19,969

  • 11c · Fees: accounting

    total $3,801 · management and general $3,801

  • 11f · Fees: investment management

    total $27,285 · management and general $27,285

  • 11g · Fees: other

    total $879 · management and general $879

  • 13 · Office expenses

    total $5,864 · fundraising $5,864

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $764,593 · end of year $741,225

  • 3 · Pledges and grants receivable

    beginning of year $900

  • 11 · Investments: publicly traded securities

    beginning of year $3,683,892 · end of year $5,089,579

  • 15 · Other assets

    beginning of year $19,602 · end of year $21,102

  • 17 · Accounts payable and accrued expenses

    beginning of year $97,287 · end of year $14,416

  • 27 · Net assets without donor restrictions

    beginning of year $2,305,628 · end of year $3,834,928

  • 28 · Net assets with donor restrictions

    beginning of year $2,066,072 · end of year $2,002,562

Mission and programs · 2022

Mission

TO GENERATE FUNDS TO SECURE THE FUTURE OF COMMUNITY HOSPITAL BY STIMULATING PUBLIC AWARENESS AND SUPPORT.

Activities or mission (Part I)

TO SOLICIT GIFTS, GRANTS, DEVICES AND BEQUESTS FOR THE USE AND BENEFIT OF COMMUNITY HOSPITAL ASSOCIATION OF MCCOOK.

  • TO AID COMMUNITY HOSPITAL ASSOCIATION OF MCCOOK BY THE SOLICITATION OF GIFTS, GRANTS, DEVICES AND BEQUESTS EXCLUSIVELY FOR THE USE AND BENEFIT OF THE HOSPITAL OR ITS PROGRAMS AND SERVICES. COMMUNITY HOSPITAL ASSOCIATION OF MCCOOK PROVIDES ACUTE, PREVENTATIVE, AND OTHER HEALTHCARE SERVICES ON A NONDISCRIMINITORY BASIS AND IN AN ENVIRONMENT WHICH IS RESPONSIVE TO THE UNIQUE NEEDS OF ITS PATIENTS. FUNDRAISING ACTIVITIES INCLUDE A GOLF TOURNAMENT AND CONCERT.

    Expenses $451,820 · Grants $451,820

As filed on the 2022 return.

Listed in Part VII

  • Troy Bruntz

    MEMBER

    Total calculated
    $340,033
    From this org
    $0
    From related orgs
    $297,126
    Other
    $42,907
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $289,611 related
    Bonus
    $0 + $6,148 related
    Other
    $0 + $1,367 related
    Deferred
    $0 + $21,202 related
    Nontaxable benefits
    $0 + $21,705 related
    Filer's total
    $0 + $340,033 related
  • Jessica Bortner

    EXECUTIVE DIRECTOR

    Total calculated
    $127,486
    From this org
    $0
    From related orgs
    $91,211
    Other
    $36,275
    Hours/week
    40
  • Neil Gohl

    CHAIR

    Total calculated
    $0
    Hours/week
    1
  • Bruce McDowell

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1
  • Jim Hall

    SECRETARY

    Total calculated
    $0
    Hours/week
    1
  • Matt Tiller

    TREASURER

    Total calculated
    $0
    Hours/week
    1
  • Beth Siegfried

    TREASURER THRU 12/22

    Total calculated
    $0
    Hours/week
    1
  • Dawna Bates

    MEMBER

    Total calculated
    $0
    Hours/week
    1
  • Kristin Stagemeyer CPA

    MEMBER

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • Kurt Vosburg

    MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related
  • Cathy Kenny

    MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related
  • Ashley Vontz

    MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related
  • Rick Haney

    MEMBER THRU 12/22

    Total calculated
    $0
    Hours/week
    1 + 1 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

None.

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 3
THE EXECUTIVE DIRECTOR, JESSICA BORTNER, IS PAID BY COMMUNITY HOSPITAL ASSOCIATION OF MCCOOK, A RELATED ENTITY. THE PROCESS FOR DETERMINING THE COMPENSATION OF THE EXECUTIVE DIRECTOR (ED) IS AS FOLLOWS: THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS IS RESPONSIBLE FOR SETTING THE SALARY OF THE ED. ANNUALLY, THE COMMITTEE CONDUCTS A REVIEW OF THE ED'S PERFORMANCE, ABILITIES, AND OVERALL EFFECTIVENESS. THE COMMITTEE IS PRESENTED WITH SALARY AND COMPENSATION SURVEY DATA THAT IS COMPILED BY THE HUMAN RESOURCE DEPARTMENT. ALL SOURCE DOCUMENTATION IS GIVEN TO THE COMMITTEE AS WELL AS SUMMARIES PROVIDED FOR EASE OF REFERENCE. THE EXECUTIVE COMMITTEE CONDUCTS THE PERFORMANCE REVIEW WITH THE ED AND FOLLOWS WITH A MEETING IN PRIVATE CHAMBERS TO DISCUSS THE REVIEW AND TO DELIBERATE ANY AND ALL CHANGES TO THE EMPLOYMENT AGREEMENT, INCLUDING COMPENSATION AND GOALS FOR THE FOLLOWING YEAR. CONTEMPORANEOUS RECORDS ARE KEPT OF ALL SURVEY AND COMPARABILITY DATA USED ALONG WITH THE RESULTS AND DECISIONS OF THE EXECUTIVE COMMITTEE'S MEETING ON COMPENSATION.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Provenance

Return type
form_990
Tax year
2022
Filed
8 May 2024
IRS schema version
2022v5.0
Source object
202401349349302225

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

The source document this was parsed from is served over the API, which is where bulk and document access live.